New Care Act legislation – Just what is well-being?

Kate Sheehan, a respected Occupational Therapist with over 28 years of clinical experience examines the importance of ‘well-being’ which underpins the new Care Act legislation coming into force on 1st April, 2015.

From 1st of April 2015, the Care Act is set to modernise the welfare system and bring social care legislation into the 21st century. It will do this by replacing numerous outdated pieces of social care legislation. The Chronically Sick and Disabled Person Act (CSDP) is one such piece of legislation set to go. While this legislation has been good for the employment of Occupational Therapists, it and other pieces of social care legislation have failed to keep pace with the modernisation programme in health and social care, particularly around the agenda of personalisation. The new Care Act is attempting to address this imbalance by empowering and trusting people to take responsibility for their own social care needs. The Care Act is also making a bold statement by making “well-being” the focus of social care provision. But what is well-being?

To have well-being at the centre of this new legislation is certainly welcomed, as we all intuitively know why it is important. However, putting into words what we mean by well-being is much more difficult. Nevertheless, this is what thousands of social care professionals, including Occupational Therapists, will need to be able to do as their work begins to be shaped by the responsibilities they will have under the new Care Act.


Despite the Oxford English Dictionary defining well-being as ‘the state of being healthy, happy, or prosperous,’ the Care Act has failed to provide such a succinct definition in the legislation. Fortunately, the published guidance for the Act has been more helpful in this matter. Though the guidance does not define well-being as such, it does provide what some commentators are calling ‘the well-being principles’.

While some people have criticised the Care Act for not providing a definition of well-being, it could be argued that principles are more useful to individuals who will be affected by the legislation and also professionals who implement it. This is because the principles help us to consider nine distinct concepts that directly influence a person’s health, happiness, and prosperity. The guidance lists the nine wellbeing principles as:

  • Personal dignity
  • Physical and mental health and emotion well-being
  • Protection from abuse
  • Control by the individual over day-to-day life
  • Participation in work, education, training, or recreation
  • Social and economic well-being
  • Domestic, family and personal
  • Suitability of living accommodation
  • The individual’s contribution to society

For those individuals affected by the Care Act legislation, the positive news is that the guidance considers aspects of well-being beyond just basic activities of daily living. It recognises that well-being includes the person’s need to contribute to society, and their ability to have control over their day-to-day life. For professionals, the guidance gives them the authority to think more holistically about what contributes to well-being. Looking at the principles, we can see it does this by including a range of factors from the design of the home, to protecting a person from abuse.

Look at any definition of occupational therapy you will see that the word well-being is at the heart of what we do. Well-being may be difficult to put into words but from the 1st of April 2015 the Care Act guidance will help us by providing the well-being principles. In addition, unlike the previous legislation, the Care Act has the potential to move social care into the 21st century. It will do this by introducing well-being concepts that moves social care provision from services that are delivered to people, to services that empower those who rely on social care to control their own needs.

Now social care legislation is entering the 21st century, is it time to also consider how we replicate this approach to fund and deliver social care services?